34 comments:

At the company I worked at before I went to med school, my friend's wife was pregnant and due any day. One morning she called in and told him that she was in labor and going to the hospital. My friend's manager refused to let him go, and threatened to fire him if he did. It wasn't as though he was performing some vital function either, or that there was nobody available to cover for him, the company just had a "no sick days ever" policy and really would fire you if you took too many (I had a friend who took 4 days off one year for migraines who got the axe over it. If you took even one day, they'd bring it up as something you could "improve upon" at your year end review.).

My friend (the one with the baby) subsequently had an outbreak of shingles and couldn't touch his wife or new baby for the next 2-3 weeks, so I guess the manager got what he wanted after all.

I don't have a story, but only because I can't imagine ever calling in sick during med school or residency. Unthinkable, seriously unthinkable, unless maybe you had been admitted to the hospital. In which case you still might be expected to round on yourself.

(Anon here from above)I do, however, remember the chief resident on the ortho service whose wife paged him when her water broke with their second baby. He was in the OR and insisted on finishing the case, a routine fracture repair for which we had a resident, PA, and med student scrubbed in, in addition to the chief and attending. He returned to round on patients while his wife was in labor. Two days later, when she and the baby were ready for discharge, he drove them home on his lunch break and came back in the afternoon. I think he was gone for an hour.

So call this guy and tell him I'm calling in sick because of a GI virus? Um, yeah.

P.S. to my original Big Name Clinic story. I confronted the office manager after my dental episode and told her she gave me too much unnecessary grief. Her answer: "If you think Big Name Clinic is an easy place to work, it is not." I hear now after having lost 3 out of 4 originally hired internists, the executive team keeps questioning why are internists so unhappy in this place. But then again the Clinic looses its entire neurosurgery department every 2 years. So, some never learn.

As a med student on internal medicine, I caught a really nasty cold that progressed to an ear infection/tonsillitis. Because I wanted to get into an internal medicine residency, I persevered with going to work until I hit the point of not being able to get out of bed, and I ended up missing 5 days of work because I was so sick. When I got my final evaluation for the rotation, one of the comments said "Rotation was noteworthy for a significant number of absences", no mention that the absences were due to me being unable to move. I challenged the attending on the evaluation, but he refused to change it (or even add in mention of the fact that the absences were due to being sick).

A fellow resident (in another program) was recently sick enough to have to be in the emerg for 24 hours before being DCed to home. Despite the emerg doc phoning the resident's program to say that she would require at least a week off, the chief resident came by her house the next day to make sure that she was "legitimately sick".

OK, none of mine are that bad...I was on night float over Thanksgiving my third year of residency. On Thanksgiving Day I had a bad cold. Slept much of the day, woke up in time to have a little turkey and then went to work at 10:00 PM as scheduled (we had a sick call resident but she was skiing four hours away). During the night I developed worsening ear pain, headache and congestion, which I treated with Diet Coke and Sudafed and ibuprofen. By 5:30 AM I was sitting in the ER conference room with shaking chills and additional tremor from all the Sudafed and caffeine. One of the nurses came in, stuck a thermometer in my ear, and showed me the screen: 103.

I waited until 6:30 and called the admitting resident, who was due to pick up the pager at 9:00 AM, after conference. I asked him to come in early or at least skip conference, and he said "no" - and went on to add "and don't leave me any admissions to write up, either". This was one of my classmates.

My story should have a happy ending. The program director happened to walk in through the ED at 7:15 and the same nurse suggested he stop in and talk to me. He took one look at me, touched my forehead, and sent me home with instructions not to come back that night. I did as I was told - and on Monday was rewarded by a hissy fit from the classmate I'd called. Sigh.

Sorry to burst your bubble. I called in sick once during residency because of a GI bug. I was an intern working a weekday shift in the ER. The third year resident on backup took my shift with no questions asked and though I couldn't pay her back, I offered to take her out to lunch and she still wouldn't have it. Now she's a great friend and a colleague with me at the same place we trained. In my program there are a handful of residents that always seem to be sick (one with a legit medical reason) and the other residents get whiny when they have to cross-cover. I tell them that if they were in a similar situation that the resident in question would have their back two times over (totally true).

As an attending, I called in sick a couple of months ago because a raging sinus infection left me prostrate on the couch. I was scheduled to be in clinic in the afternoon. I emailed my boss and his secretary at 4 AM when I realized there was no way in hell I was going to be functional after having been awake all night unable to breathe. He called me a few hours later to make sure I was ok and didn't need antibiotics called in and said to come back when I felt better. A colleague covered for me and refuses to be paid back, either monetarily or by covering for her.

That is just one of the many benefits to having the best job in the world. :)

surgical subspec resident became septic with a pharyngitis/tonisillitis thing and stayed in the ED for 24 hours getting iv abx. Chief of program called asking for definitive proof - even after the staff ER doc called and confirmed. After d/c to home for 5 days of ongoing treatment/rest the sick resident's chief of subspec department would call/txt page him 'hoping he was getting better' because it would be really bad to see him out and about and still not back at work (*/end thinly veiled threat). Being a junior he simply had to 'put up or shut up' as his staff attending told him.

I have 2 stories. The first was during my 3rd year med school internal medicine clerkship. My oldest daughter had strep throat and my husband (who worked 2nd shift) had to leave for work at 3pm. At 2:30pm I left for home, after finishing all patient care tasks and getting the ok from the chief resident. At 4pm the chief of cardiology came looking for all the med students so they could listen to an interesting heart murmur. He was furious that I had left for home to care for a sick child. He gave me a "fail" for the rotation, although I appealed and was eventually passed.The second episode was the following year. I was on an outpatient rotation, and I had an ovarian cyst rupture. I waited until Friday clinic was over, then went to the ER and was admitted for laparoscopic surgery. I was discharged the following day (Saturday) and returned to work on Monday. I was still fatigued from the whole ordeal, so on Monday during my lunchtime I went out to my car to sleep. I set the alarm on my beeper and was back in clinic before lunchbreak was over. Nonetheless, somebody somehow knew I had snuck out to sleep and informed the attending. On the end of rotation evaluation, the only comment was, "sleeps when she should be working".During my residency, my husband and I spent every single one of our vacation days at home caring for sick children (I have 3 kids, and one is accident-prone). When I finished residency and fellowship, he became the stay-at-home parent, to my great relief.

I suffered a miscarriage during one of my M3 rotations. It was 4 am on an overnight, Friday-to-Saturday call during which I'd had no sleep and barely time to even sit down. I'd been in the hospital and running for a full 24 hours. I started bleeding (profusely) while doing an H&P on a consult patient. I immediately excused myself, found the chief-resident - who was having a non-work conversation with a colleague and kept holding her hand up to silence me when I tried to speak - and told her I was pregnant, bleeding, and heading to the ED. Her annoyed reply: "Well, you need to find Dr. Attending first and let him know. And I need you to tell me what you learned about this patient." I gave easily the worst case presentation in the history of presenting and, in tears, located my attending, who scowled, shrugged, and waved me off with a "Do what you have to."

I had my post-call day (Saturday) off and, thankfully, was scheduled to have Sunday off as well. However, policy for this particular clerkship is that any missed call days must be made up or the clerkship repeated (yes, the WHOLE clerkship repeated) in the M4 year. I received an email from the clerkship director Saturday afternoon stating that my leaving at 4am - before 5am rounds - constituted an incomplete call shift. She was sorry for my loss, but could make no exceptions concerning the call shift rules. Sunday was my last chance to make that call day up before I took my shelf exam and moved on to my next rotation. So, I went to work on Sunday. I took my shelf on Monday. And I attended the mandatory am orientation and first pm clinic of my next clerkship on Tuesday.

I Honored both the clinical and examination portions of the clerkship, and got wonderful comments from my superiors, including that crappy chief and the unbudgeable director herself. But when I see either of them around the hospital these days, it's all I can do to keep my mouth shut around the harsh words that spring there at the memory of their gracelessness. If there is a word powerful to describe the whole, cold experience, I haven't found it yet.

My co-op resident had a miscarriage one day while on our NICU rotation, and called the chief to call out, and was told the pregnancy was over, so she has no excuse, and the chief would not call in back up. She went to work, bleeding, and extra depressed around all of the newborns.

During an ER shift as a PGY-2, I had an asthma attack. A fellow resident listened to my lungs, announced my wheezing, and had a nurse hook me up to a duoneb. During my nebs, the head of the ER came over and made me register as an ER patient, BUT NOT stop my shift. So I wrote my own chart on myself (I was literally my own Doctor), and got a few nebs in between seeing patients, and finishing the shift (2hours late of course, to make up for any personal time I took by getting nebs and filling out my own chart). The worst part was getting the bill from the ER! I had to pay $200 (which was a lot of $ for me as a resident with lots of med school debt and a baby), and saw the ER charged my insurance another $2000 to give me $5 worth of meds.

During my residency (recently) a lot of people did call hooked up to IVs. 1 guy had to be rushed to surgery during a call, but nobody gave him shit for needing back up... But they would have if he had called out earlier.

on a sunday call for ob/gyn as a pgy-2, i started off the shift feeling okay, but by noon was vomiting every 10-15 minutes. i muddled along much of the afternoon, seeing patients in emerg and doing assessments in l&d triage (history - barf - exam - barf - plan - barf - call staff - you get the picture). finally, around 5 or 6, i worked up the nerve to ask my staff (who was in house, watching movies in his call room) if i could pass him my pager for a couple of hours to rest and rehydrate. without even a pause for consideration, the reply was - 'who would see the patients?'. i wound up with a saline lock that i hooked up to an iv bag whenever i got a spare moment to sit down and a dose of zofran from a kindly emerg doc who took pity on me.

more dramatically, a resident in my program was on call friday/sunday. his wife went into labour friday night and delivered late saturday afternoon. the general vibe from the staff and chief was that he should have 'planned better' (i.e. psychically known when his wife would go into labour) and would not let him off the hook. another resident had 3 (yes, 3) miscarriages over her pgy-3 year, and happened to be on call with each one. she bled down to a hemoglobin of 60 with her third (we checked in the am) and the only response from the staff was 'huh, i thought that she was being lazier than usual'.

I'm a med student in the UK and I'm somewhat amazed by these stories. I'm in London, i.e. the top 5 schools in the country, and I know people from all of them. (I don't mean to boast but it's relevant.)

We have 3 clinical years unlike 2 in the US. In the 1st year, you really don't need to show up at all and can still come in the top 10% of the year. You just need someone to sign a piece of paper once a month, and usually they don't even know who you are - just find them on a round and say "sign this please??" and they will do it without looking at you usually.

When I feel a bit woozy (mild headache) I just go home, nobody knows or cares. In our final clinical year it gets a bit stricter, as in you need to be seen in the hospital at least once a week. Obviously most people do want to be good doctors, so they come in more often than that, but it's mostly still based on trust.

Even when you graduate, most new doctors are paid until 5pm, so at 4.45 they finish up with the patient they are seeing, do a quick handover to the night shift and then go home. Though some places don't make you do night shifts until equivalent of PGY3.

A lot of my friends are doing the USMLE as our internships take 2 years whereas I believe yours are only 1. I think they will be in for a surprise if they get a place and cross the pond.

wow I just came across your blog and these stories are very sad! I can't believe how mean can people be and don't realize we all get sick!!I just came across your blog through another one about Pathologist Assistant which is what I'm planning on doing for grad school, although med school is still in the back of my mind but these stories are scary! I don't know how you all can do it with families and all that. Hats off to you.

None of my stories are this bad yet, but I'm just a med student so maybe I will have more later. I did have one instance where I was coughing up blood, and my attending wouldn't let me go to the clinic, saying that "doctors don't have time to get sick." When I got lightheaded and nauseated, I finally told him I was going to see my doctor and I'd be back after getting some antibiotics. My doctor told me I was not allowed to go back and see patients, as I would infect them, and she called the attending. I took the rest of that day off but was in to work the next day. I have decided that if I am treated as badly as in some of the posts above, I will unapologetically leave the job I am in, or if necessary, the medical profession itself. There are just some limits that should not be crossed. We are all human beings and should be treated with basic respect for the most basic needs like sleep, food, going to the bathroom, and being sick. If I am sick, I will take a day off. And if supervisors fire me for that, then I should be in a different profession where I can be a person. This is what I have decided.

Well mine isn't so bad but I was on ICU in my 2nd to last month of my 3rd year of IM residency when I had a fetal demise. I missed a call my delivering my stillborn fetus and the resident who covered actually made me pay him back

I think I got lucky to be in a good program, in a (mostly) nice specialty (FM). We had one resident who was out of country for some time - I actually ended up doing several more calls than she did but it wasn't worth getting upset about, that's just the way things work out sometimes. Another colleague had to have surgery but he could hardy help that and admin didn't give him a hard time about it - he wanted to come back early actually but we preferred him fully healed.However, we had a (real slacker) resident one year that missed a week of medicine for being "sick" ( very doubtful)... someone had to do all his work for the entire week.... IMHO by day 2 he should have had a hospital admission going on (at the very least, a doctor's note) or been at WORK like the rest of us. He definitely took advantage of a very laid-back program.

Yikes -- I think I have it easy being in the friendly field of pediatrics, and mostly my colleagues have been great about covering when needed. However, I do have an example of harsh treatment when, as an intern, I had a horrible case of RSV. (Pediatrics residency is a huge risk factor for adult-onset RSV.) I was presenting my many new admits post-call and had to stop every couple minutes in my presentations to turn around and cough/hack harshly for 10-20 sec while everyone stood around waiting for me to continue. Finally, there was a break in our rounds, but I had one presentation left to give after the 20 minute break, and I could barely stand up. I turned to my senior resident and begged her to cover the last presentation so I could go home and recuperate. She shrugged and said no, I had to do it. (And here's where a surgeon would have complied, but a pediatrician can't take it. . . ) I ran off to the chief resident's office and sobbed about how sick I was and she agreed that I could go home to rest and cough in peace. So it does have a happy ending, although I still resent that older resident who wouldn't step up for me.

There are some powerful lessons in these stories that those of us at the beginning of our medical training (like me, a bright-eyed and bushy-tailed MS3) can keep in mind in the future. As interns, residents and attendings, we can all remember how we liked to be treated as trainees, and model the kindness we might not have been shown. I hope that as a resident supervising medical students or interns that I will allow a sick day or two, or take a pager for a few hours to allow a colleague to eat a meal or get an hour of rest, or give a presentation on rounds for someone if I see tears in the corners of his eyes. I completely refuse to buy into the idea that medical training must be cruel and inhumane, or that we must punish our trainees for unkindness that we experienced in their shoes.

These sick day experiences are one facet of the grueling training that we go through. Even just in the first half of my 3rd year, I've experienced some incredibly kind and compassionate moments from residents and attendings, as well as some unbelievably rude behavior. On my medicine rotation, my resident watched me become unglued after an attending ripped into me during a presentation, she took me aside, sent me off to take care of some scut work, and told me I was doing an incredible job on the team otherwise. On Surgery, at attending berated me for two hours after missing a pimp question. When I have a choice about how to treat trainees, I will obviously choose the former.

my junior resident (in neurology) developed acute appendicitis while on call last year. he ran himself through the CT scanner, then treated a stroke patient with tPA after holding a family meeting to explain the patient's critical situation. by the time he told the attending in the ER how sick he was and checked himself into a room, he was near rupture and needed an open laparotomy (WBCs near 30, temp >40). while the surgical resident was prepping the OR, another stroke came in and our resident got out of his bed to treat stroke #2! he called a chief for backup to complete his call (who was seriously irritated that don had the audacity to get sick). then, when his surgeon told him he was unable to return to work for 5 weeks, the general feeling in the department was that he was milking the situation. when he returned to the hospital, only half of the residents who had covered his calls did so for "free". the poor guy was q3 for the next month trying to make it up.

for me, the worst it got was that i was on call while 8 months pregnant AND sick with the flu... i was sicker than most of the patients i treated that night!

Wow, I'm not a Dr and these stories make me really glad about that (I'm a neuroscientist). WTF is wrong with all these jerks? This would never fly in any other field. Not to mention it's illegal. It kind of reminds me of how you're continually shot down no matter how high up you get in research academia... At least we're allowed to be sick. No one wants you around work when you're sick. They'll get mad that you've shown up. Guess it doesn't really matter if you work in a hospital, though. And these assholes are supposedly compassionate?

I'm a PGY-3 and I've at least a couple similar stories myself from getting sick, mostly after I had my baby (thank God, I didn't get sick during my intern year, which started simultaneously with my pregnancy). What bothers me the most is that medicine is supposed to be humane, but the way medical education is designed, it really sucks out the humanity of people in it. It probably is similar in other/corporate business fields too, but not with the same irony as in medicine.

During my 3rd year of Emergency Medicine residency, I was sick as a dog with the flu. Worked through the entire 12-hr shift in the Pediatric ER. After the shift, the assistant residency director made me stay late in order to get IV fluids. Notice I didn't say sent me home early or let me get some rest. Nope, she wanted me to get IV fluids so that I could be back for work the next morning. One of the worst parts about being a sick doctor is giving patients an excuse to miss work when they have the same ailments you have yet you are still working...

I caught Flu A the spring of 2009 from a patient who had just flown back from Honduras with a plane full of coughing Mexicans (they crossed the border to Honduras to fly out because the Mexican government shut down the airport in an effort to contain the spread). Showed up for work sick as a dog and couldn't get permission to leave until I manifested a fever of 104. Then the CDC got involved and I was mandated to go home for 5d of Tamiflu while my culture cooked at the CDC. I was not supposed to return until I was completely asymptomatic (you know, so as not to infect my patients with potentially deadly SWINE FLU). Yeah, that lasted for a week...then they said 'if you stay home any longer you'll have to repeat the month and you haven't had a fever in 48h...see you for work in the morning. As far as I know flu is contagious even when you don't have a fever. I was still snotty and coughing but the choice seemed to be 'suck it up and come in' or (veiled threat) 'be asked to leave the program'. The other residents on my rotation hadn't even been covering for me (having been pulled to do ER shifts to address the "my daughter sat next to a Mexican on the bus yesterday; does she have swine flu" innundation. They acted like I was a lazy bum and were resentful that I 'got a week off work', even though I was home sick with a high fever and came back to work while I was still sick.

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